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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by Phillipa on April 3, 2007, at 12:02:41
It's very depressing to me when I look at the board as it seems the only meds anyone is on is an MAOI. And does that mean that they are the only meds that work or are all the people on SSRI's doing so well they don't have to Post? See I still need to get courage to try and SSRI or another and there are no threads on them anymore. Whas't doing on? And by the way the high dose benzos still not sleeping I getting really freaked out. And the thyroid stuff complicates things even more. Love Phillipa please some SSRI or SSNRI threads?
Posted by Quintal on April 3, 2007, at 12:35:42
In reply to Are The Only Meds That Work MAOI's That's All I se, posted by Phillipa on April 3, 2007, at 12:02:41
There are still threads on SSRIs Phillipa, like Denise on Lexapro for example, but I agree fewer people seem to post here about them. Maybe people who do well on SSRIs don't feel the need to come to forums like this where the advice is more on cocktails and more exotic drugs? I'm doing quite well on reboxetine and pramipexole so far, which isn't an SSRI obviously, but it shows there is still hope for other meds.
Have you thought about working on your fear of meds in therapy? Maybe that would be a good first step to getting you back on the road to recovery? Nardil sounds like an ideal drug for you if only you could overcome your fear of it. I think it could work wonders for you.
BTW re: "how could one week of each of those meds have mattered. I would think it would take longer." Imagine someone who usually drinks a few beers at night to relax suddenly starting to drink a bottle of spirits morning and night for two weeks. Do you not think they would have a hangover if they suddenly went back to drinking only a few beers at night? That's the nearest analogy I can think of to what is happening to you and why you're having withdrawal symptoms despite still taking Valium. Please don't take that the wrong way (I'm not comparing you to an alcoholic), I'm just trying to explain to you in crude terms what's going on.
Q
Posted by Racer on April 3, 2007, at 13:38:32
In reply to Are The Only Meds That Work MAOI's That's All I se, posted by Phillipa on April 3, 2007, at 12:02:41
Other medications work for people, and there are threads about them here.
Jan, you're working yourself back into a crisis about medications right now. Truly, that isn't going to help you. Can you work with your new psychologist about ways to keep your anxiety about medications under control? Maybe discuss biofeedback?
Here's the thing: your mileage will vary. You know that, it's clear as can be if you read this board, right? You will have your own reactions to medications, so you'll have to try them to find out if they'll work for you. But if you're so freaked out by them that you only take them for two days, or three days, or a week, then you'll never know if it would have helped. A few times, Jan, you've tried to start a new medication, but your anxiety about it has been so great you haven't been able to keep taking it. It's your anxiety -- the very symptom you're trying to treat -- that's stopped you from taking a drug, and that's not doing you any good.
Way back, at the end of my long nightmare, when I started Cymbalta, I had the same sort of reaction. I'd been through such hell, and I was ready to stop the drug after the second day. I was sure I was dying, I was sure it wasn't working, I was sure I needed to stop it before Something Terrible happened to me. Well, if I had stopped it, I would have been stuck in a cycle of not being able to take anything. ALL drugs have effects that are noticeable in the first days and weeks. Mostly, those effects go away if you can get through them. The trick is figuring out how to get through that adjustment phase.
Remember Chemist? He called me every single day, and he told me to take the pill, and he listened to me telling him that it was going to put me through hell, and he reminded me that I had to keep taking it to find out if it would help me. Without him, and his good sense, I wouldn't have gotten to where I am now. I think you need to find something like that for yourself, Jan. I think you need someone to give you some gentle bullying to get you through the adjustment phase. Maybe that's your new therapist, maybe you've got a friend who'll do it, maybe your husband, maybe Babble -- just, somehow you've got to get yourself ready to take a new pill that will make you feel funny for a while. If you can't do that, no medication will help you.
Good luck.
Posted by stargazer on April 3, 2007, at 17:43:13
In reply to Are The Only Meds That Work MAOI's That's All I se, posted by Phillipa on April 3, 2007, at 12:02:41
Phillipa, You know the people who are on PB so often are those that have very difficult cases of depression, anxiety, etc. and are beyond taking an SSRI or monotherapy for their condition. That is why you do not see many straight forward stories of SSRI's and other first line treatments used initially for depression. The success stories on SSRI's are in many whose lives are not all consumed with these conditions. They are working and living relatively normal lives. At least, that is what I think.
You and I see things very differently. I look at the MAOI stories and feel good that there are many success stories (not always) especially since so many of the users have requested the MAOI's when all their pdocs want is to give them SSRI's or other "new, improved" meds, which have proven do not work for so many of us. Those of us who have spent years going that route know it can just be a futile endeavor and time is being wasted, with every med trial.
Finding a MAO or other combination of meds that work is real progress and success, so don't look at the stories as depressing. They are inspiring, if you look at it from someone's long journey to get there. We are the experts, not the pdocs, although some are, but the majority of us probably have average pdocs, the superstars are few and far between.
If I were in your shoes, I would say I have more to lose by not taking a MAO or something like it. Low dose Nardil worked very well for my social anxiety which is really the way my depression started out. It was a true miracle and hopefully I can try it again very soon. I have no fear of trying MAO's since I've tried 4 and have not had anywherer near the SE's on them as I have had on SSRI's. I have essentially refused to ever take an SSRI again if I am thinking clearly at the time, which can cloud my ability to make good decisions for myself.
SSRI's give me horrible side effects including a worsening of depression to the point of being suicidal. I was the one who told my doctor if he insisted on me upping my dose, he would have a dead patient on his hands. Needless to say, stopping the SSRI saved my life since the suicidality left as quickly as it had comeon.
If I were there, I would be your advocate for trying Nardil since it is such a good drug and the SE's for me were so minimal. It really did give me a life. That was almost 20 years ago. Why these insane pdocs don't use logic is beyond me.
So much for all the great meds of the 90's (Prozac, Paxil Effexor, Zoloft, Celexa (OK),Remeron) none gave me any relief on their own. Occasionally when combined with something, like Wellbutrin or a stimulant the combo worked but it wasn't the SSRI that was doing anything.
Please take the initiative and help yourself. You can't get much worse than where you are at right now. You have to take a new course and try something different. Not benzos and not SSRI's, at least in my opinion, they are not working.
You need a new approach and everyone here has tried to encourage you but your resistence puts up so many roadblocks, we can only do so much to help you. You are getting more and more depressed and anxious that you are your own worst enemy for seeing any real logical solutions.
I do think a different approach is key to you getting better, you need to find an alternative to benzos and Luvox or other low dose SSRI's. If you never have tried a MAO you owe it to your self to try one at least once and not to focus onthe negatives because you can always convince yourself why not to try one.
Be well...Stargazer
Posted by Phillipa on April 3, 2007, at 19:45:21
In reply to Of course not » Phillipa, posted by Racer on April 3, 2007, at 13:38:32
Racer I know you are right. One of the reasons I come here and post so often. I have spoken to the PHD therapist already and asked that we work on my fear of meds. So tomorrow will be the beginning of that. I used to e-mail with chemist and miss him. Can you help me with a question please? Why was I able to take cymbalta at 60mg for months and not feel any side effects. So since I felt it wasn't working went off it. Then when we moved here I didn't like or trust the first pdoc I saw and he said cymbalta 30mg l week, 60mg 2 week , and 90mg 3 week, and then l20mg. I couldn't tolerate it then. Was it trust issues? I know you can't know for sure. But the worst part I think is trying SSRI's during peri-menopause and not post menapausal my chemistry must have changed. That's an example. And the other fear is the big changes in my thryroid and I figured something out today. When I started seeing the endo I was taking my synthroid with breakfast and was stable for 9years thyroid wise. But he said an hour before breakfast and said to take it during the night. Could I have a trigger that keeps me from sleeping knowing I have to take it then? Love Jan
Posted by Phillipa on April 3, 2007, at 19:49:05
In reply to Re: Are The Only Meds That Work MAOI's That's All I se » Phillipa, posted by Quintal on April 3, 2007, at 12:35:42
Quintal there were so many on SSRI's a while back and the atmosphere has drastically changed I wonder if it's scaring the SSRI users away? I suggested one time on admin a separate board for MAOI's I believe although I could be wrong. But I would love to see one. They just aren't using MAOI's here where I am or in this state. That I know of. My old pdoc had one patient from years ago on an MAOI. But even she doesn't use them. Love Jan
Posted by Phillipa on April 3, 2007, at 19:55:28
In reply to MOAI's work, that's why all the posts/Phillipa, posted by stargazer on April 3, 2007, at 17:43:13
Stargazer I'm off the luvox because of you guys. I only wish I'd gone up high on it one more time to see if it would work. I have made some changes because of you guys I love you all. But as I said to Quintal I know of no one here. So someone maybe come out of hiding in North Carolina near Charlotte with a name? But Racer had a good point in my other thread that I trusted the new pdoc so I took her advise and stuck with him. And he's the one who wants a baseline. My fear with him is that on the phone yesterday he mentioned cymbalta and antipsychotics. And no I refuse antipsychotics. So what to do? Love Jan
Posted by Racer on April 3, 2007, at 20:13:11
In reply to Re: Of course not » Racer, posted by Phillipa on April 3, 2007, at 19:45:21
> Can you help me with a question please? Why was I able to take cymbalta at 60mg for months and not feel any side effects. So since I felt it wasn't working went off it. Then when we moved here I didn't like or trust the first pdoc I saw and he said cymbalta 30mg l week, 60mg 2 week , and 90mg 3 week, and then l20mg. I couldn't tolerate it then. Was it trust issues?
Actually, I remember that clearly. At one point you wrote something like, "I didn't know how strong it was then, so it didn't do anything to me..." (Sorry -- I don't remember exactly when it was, and don't have time to search.) That's the anxiety -- when you were given a pill with little additional information beyond, "Take this, it'll make you feel better," you had no problems. The second time you tried it, when you'd been here and read all sorts of horror stories, you were nervous about taking it -- guess what? You experienced problems.
That's what I meant about it being up to you. Hard as it is, you've got to find a way to get over that -- at least for a while. At least long enough to get past the adjustment phase.
Listen -- I still do it, myself. Right now, I'm all tied up in knots about being on Prozac again, because I'm afraid I'll gain even more weight. And it's all I can do to stay on it, even though I can remind myself that if it happens, I can do something about it. It *feels* as though whatever happens is forever.
It's not forever.
How about this: how many problems can a drug cause that never get better? I can only think of one thing a drug can do that you can't get over, and none of these drugs will actually kill you. Everything else, you can deal with. Allergic reaction? Stop taking it. Upset stomach? It'll go away, either in two weeks, or when you stop taking the drug. Headache? Either it'll go away, get better, or you can take ibuprophen. Insomnia? There are sleeping pills and schedule changes. Sedation? Augment with a stimulant or Provigil. Anxiety? Maybe a low dose beta blocker until it passes. Those are the sorts of things I've seen drugs cause, and there's something to be done for nearly all of them -- if they happen at all.
So, Jan? Maybe asking yourself what you're really afraid of would help.
Good luck.
Posted by Quintal on April 3, 2007, at 20:14:57
In reply to Re: MOAI's work, that's why all the posts/Phillipa » stargazer, posted by Phillipa on April 3, 2007, at 19:55:28
I didn't factor in that you might have so much trouble getting a pdoc to prescribe an MAOI Phillipa. If you trust Cymbalta because you've tried it before then it may be worth giving it one last try and perhaps trying to augment it with something. Have you considered going back on estrogen cream? I read in my pharmacology textbook that it is helpful for boosting response rates to antidepressants. According to the book some women only start to respond to antidepressants when they take estrogen therapy. It actually encourages the synapses in your brain to grow new connections.
I don't like antipsychotics myself, so I support your feelings regarding that route. Would you be willing to try EMSAM if you could get a pdoc to prescribe it Phillipa?
Q
Posted by FredPotter on April 3, 2007, at 21:28:56
In reply to Re: Of course not » Phillipa, posted by Racer on April 3, 2007, at 20:13:11
Phillipa we are mostly hard-to-treat depressives and anxiety sufferers here because those that respond (to SSRIS say) are not here. I had to persuade my GP to prescribe Nardil and the pharmacist was afraid they would soon stop making it as it was so old!
After 2 weeks it's a bit early to say. Side effects, grogginess, probably weight gain, possibly increase in blood sugar. Positive effects I've noticed are my brazen sociability, better decision making and not taking any sh*t from anyone - angry sometimes, when it's deserved. Do try it
Fred
Posted by Phillipa on April 3, 2007, at 21:30:42
In reply to Re: Of course not » Phillipa, posted by Racer on April 3, 2007, at 20:13:11
Racer I clearly remember it as the very first time my husband found babble I had just been given cymbalta by the only pdoc when we lived at the beach. And low and behold a person named Scott was going on it. We both followed his progress and when it failed I thought the same would be my case. Now I had no idea that Scott was TRD. So we took it as that was what it did. And I carefully weaned off it as others were doing at the time by dumping some of the capsule out. I know I have to get over this my fear is death. As no one took me to Church or taught me faith consequently I think of my age and death a lot now and think oh they dig a hole and that's it. It's a big problem for me. At one time I posted a thread on Faith about an experience of mine and it was slammed down. I need say nothing further on the faith as I'm sure you know what I'm talking about reguarding posting it where I did. Racer I'm seriously so happy for you and your remission. I truly am. And thanks for helping me. I know how frustrating I am. Love Jan
Posted by football on April 3, 2007, at 21:35:19
In reply to Of course not » Phillipa, posted by Racer on April 3, 2007, at 13:38:32
"Way back, at the end of my long nightmare, when I started Cymbalta, I had the same sort of reaction. I'd been through such hell, and I was ready to stop the drug after the second day. I was sure I was dying, I was sure it wasn't working, I was sure I needed to stop it before Something Terrible happened to me."
Weird. The exact same thing happened to me when I tried Cymbalta. And it's supposedly a "safer" drug..."Well, if I had stopped it, I would have been stuck in a cycle of not being able to take anything. ALL drugs have effects that are noticeable in the first days and weeks. Mostly, those effects go away if you can get through them. The trick is figuring out how to get through that adjustment phase."
There's no trick. It all depends on how much you want to get better. Which is worse, a couple weeks of annoying side-effects, or never getting better?
On Nardil, I've been dealing with three weeks of constipation, dizziness, weakness, dry mouth, blurriness when I try to read something, sexual problems, head-aches, difficulty urinating, lack of any appetite, and I have to make sure what I eat won't kill me.
However... I'm toughing it out. Many of the side-effects are starting to subside, and guess what? I'm feeling less depressed then I've felt in years and my anxieties, while not yet as improved as depression, is well on it's way.It would be great if they could develop meds tailer-made for each person that would have no side-effects and work perfectly, but in the year 2007, this is the best they can do.
Of course, if you really are just completely fed up with meds, you do have other options to get better...-ECT: is very effective, but kinda scary sounding and does cause short=term memmory provlems
-Magnetic Therapy: Static Magnetic Fields - amazingly, studies show that it might even be more effective then ECT. Seems like a great option for you. Have you considered it? Also you have a thyroid problem, right?Check out this link...http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S-43G2WK9-5&_user=10&_coverDate=07%2F01%2F2001&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c22a9872303ea6a818f39751a4b42424
-Mediation: atudies show that meditation can be very effective-Nutritional Supplements: An interesting option. Outside of Kava Kava and St. John's Wort and 5-HTP I don't know much about any of them and there's been very few scientific studies. However, what I found so interesting is while browsing the Remedy Find Nutritional Supplement section, is how many people managed to find a mirical drug for them that most people have never heard of. If you're sick of the traditional meds, it may be worth looking into.
Posted by Phillipa on April 3, 2007, at 21:39:55
In reply to Re: MOAI's work, that's why all the posts/Phillipa » Phillipa, posted by Quintal on April 3, 2007, at 20:14:57
Quintal don't please confuse me further as the old pdoc had said she'd use EMSAM then when she used it on a few patients she told me it was too stimulating for someone with anxiety as high as mine. No I don't trust cymbalta as that doc hear messed me up. The only way I'd try it again is if the pdoc here let me take extremely low doses first and build up . As the time up here I thought my head would explode as I couldn't cry. It was horrible. And you guys helped me make the decision to stick with the guy here. As far as hormones I used bioidentical ones made at a compounding pharmacy at the beach as I couldn't tolerate the synthetic ones. So what about the creams you get in the health store and do they do anything if you have already been through menopause? Love Phillipa ps My daughters e=mails I sent her came back to me too. Talked to her on the phone and have no reason why
Posted by Quintal on April 3, 2007, at 21:41:56
In reply to Re: Of course not » Racer, posted by Phillipa on April 3, 2007, at 21:30:42
Jan, I'd recommend you read "The Tibetan Book of Living and Dying" by Sogyal Rinpoche if you've never done so already. It could give you some peace of mind re: death, aging, the purpose of misery and suffering. At the very least it is an inspiring read, and I think it did help me a lot in getting through benzo withdrawal last year. Seriously, give it a go. It's like 'chicken soup for the soul', you can hardly help but feel soothed and uplifted by it.
Q
Posted by Phillipa on April 3, 2007, at 21:59:51
In reply to Re: Of course not, posted by football on April 3, 2007, at 21:35:19
Football so did cymbalta end up working at all for you? And today I started wondering about SAMEE sp? as that maybe is tolerable for a start. Don't know. Love Jan
Posted by Phillipa on April 3, 2007, at 22:07:57
In reply to Re: Of course not » Phillipa, posted by Quintal on April 3, 2007, at 21:41:56
Quintal thanks will look into it and see if our library has it. Love Jan
Posted by FredPotter on April 3, 2007, at 23:06:38
In reply to Re: Of course not » Phillipa, posted by Racer on April 3, 2007, at 20:13:11
but ibuprofen can cause stomach irritation, so not a good painkiller if you have a headache AND stomach ache
Posted by willyee on April 3, 2007, at 23:09:26
In reply to Are The Only Meds That Work MAOI's That's All I se, posted by Phillipa on April 3, 2007, at 12:02:41
As the poster below put it,i believe its perfect.You take frienly but harsh nudges personaly,perhaps you can think of it in these terms....."you are at war with your mind,and you should have a part in the fight,not just leave it to someone else,the mind is simply to precious,it controls every aspect of ever living a normal life.Also keep in mind that in a war,or in life whenever there is gain there is always a risk,and you have to somehow get over this milestone of fear you have upon starting a new drug,either over it or past it,but its time in my view that you take some of the load off the docs and believe you have the right to treat yourself to a extent,docs make us feel wrong because we dont want to sit around and wait for them to tell us every little thing,well with the info available now a days opposed to pre computer days,sitting on ur behind and not taking any part is simply illogical,its a fight and being a part of it phillipa does not make u a bad patient.Just my opinion"
> It's very depressing to me when I look at the board as it seems the only meds anyone is on is an MAOI. And does that mean that they are the only meds that work or are all the people on SSRI's doing so well they don't have to Post? See I still need to get courage to try and SSRI or another and there are no threads on them anymore. Whas't doing on? And by the way the high dose benzos still not sleeping I getting really freaked out. And the thyroid stuff complicates things even more. Love Phillipa please some SSRI or SSNRI threads?
Posted by stargazer on April 4, 2007, at 7:53:44
In reply to Re: Of course not » Racer, posted by Phillipa on April 3, 2007, at 21:30:42
Phillipa...
This past year I have tried the following meds...none of them were as bad as I anticipated and I can give my thoughts on them. The best for me has been Emsam and Abilify. With anxiety, you need to go with a less activating med and most of these were, with the exception of Emsam. Abilify gives me energy, but is not overly stimulating and works differently than the other AP's.
1.)Lamictal (Mood stabalizer): Not recommended as both you and I had problems, you had excessive salivation, I had balance probs.
2.)Seroquel(AP): this might work for you, it made me very tired, but low dose (25 mg) is a good place to start, 100 mg was too much for me. It made me forgetful and caused loss of balance.
3.)Cymbalta(SNRI): may help you, it made me too tired, even at a low dose, but may be good for your insomnia and anxiety.
4.) Emsam (MAOI): could even work for you despite others who found it too stimulating. At 6 mg, I had some stimulation at first but it has subsided now. You can use Seroquel or something else to combat this.
Rec: try it once for a few weeks.5.) Abilify(AP): I like effects, increased interest and motivation for me. I'm still on at low dose (5mg)with no side effects. You could even try 2.5 mg to start.
6.) Depakote (Mood stablizer): I never tried but it was recommended and I know is very good for anxiety. Side effect profile is MINIMAL and is safe for the elderly, meaning very safe profile and no danger with other meds. I can't try since I need energy not sedation, but for you may be great. Start at 125 mg.
7.) Other AP's: Geodon, Risperdal, Zyprexa, didn't do much for me, could work for you.
I too was very afraid of trying an AP, but after trying a few, they are not as bad as I belived and I am alive to tell my expereinces. Life has no guarantees but if you want to live and I know you do, you have to try a few at low doses.
You are such a fighter but sometimes your strength keeps you from trying things by focusing on the negative aspects of a solution. By trying some meds, you will save time by eliminating that choice which will always exist until you try it.
This is the only way we can help you, giving you our opinions and contiuing to motivate you to try things and not become paralyzed with indecision and rationale. It probably is the only thing you feel you control anymore because so much is out of your control from years of poorly controlled anxiety. It has taken its toll.
Spring is a time for rebirth...
Stargazer
Posted by football on April 4, 2007, at 19:18:12
In reply to Re: Of course not » football, posted by Phillipa on April 3, 2007, at 21:59:51
> Football so did cymbalta end up working at all for you? And today I started wondering about SAMEE sp? as that maybe is tolerable for a start. Don't know. Love Jan
Nope. I had that terrible reaction the 2nd day of taking it, and there's no way I would ever go back to it after that. I think I must just be allergic to it or something.
Posted by Phillipa on April 4, 2007, at 20:24:13
In reply to Phillipa, my experiences with AP's are OK, posted by stargazer on April 4, 2007, at 7:53:44
Stargazer did and was on seroquel in the hospital they took me off as it let me think but I couldn't talk. Love Phillipa/Jan ps you're right about the control issue too.
Posted by KayeBaby on April 4, 2007, at 21:56:36
In reply to Re: MOAI's work, that's why all the posts/Phillipa » Quintal, posted by Phillipa on April 3, 2007, at 21:39:55
> Quintal don't please confuse me further as the old pdoc had said she'd use EMSAM then when she used it on a few patients she told me it was too stimulating for someone with anxiety as high as mine. No I don't trust cymbalta as that doc hear messed me up. The only way I'd try it again is if the pdoc here let me take extremely low doses first and build up . As the time up here I thought my head would explode as I couldn't cry. It was horrible. And you guys helped me make the decision to stick with the guy here. As far as hormones I used bioidentical ones made at a compounding pharmacy at the beach as I couldn't tolerate the synthetic ones. So what about the creams you get in the health store and do they do anything if you have already been through menopause? Love Phillipa ps My daughters e=mails I sent her came back to me too. Talked to her on the phone and have no reason why
Phillipa,
Have you ever tried zoloft?
It just occurred to me that I know of a good handful of ladies who have issues similar to you that have done very well over many years on it.I have not heard of many bad experiences with it. Seems like a reliable AD for many.
Peace,
Kaye
Posted by Phillipa on April 4, 2007, at 22:02:34
In reply to Re: MOAI's work, that's why all the posts/Phillipa » Phillipa, posted by KayeBaby on April 4, 2007, at 21:56:36
Kaye baby the pdoc ordered low dose serzone today. Comes in tomorrow. I have a thread on the board. I did try zoloft only to 50mg. Love Phillipa/Jan
Posted by KayeBaby on April 5, 2007, at 1:40:17
In reply to Re: MOAI's work, that's why all the posts/Phillipa » KayeBaby, posted by Phillipa on April 4, 2007, at 22:02:34
I had a good friend on serzone forever and she loved it.
I bet it will help. You need some relief so badly.
Saying a little prayer for you.
Peace,
Kaye
Posted by stargazer on April 5, 2007, at 8:18:06
In reply to Re: MOAI's work, that's why all the posts/Phillipa » Phillipa, posted by KayeBaby on April 5, 2007, at 1:40:17
Phillipa,
Serzone will work for you. I'm thinking positive thoughts for you...
Serzone will help you regain your life back as it has for so many with anxiety...
Serzone will help you relax and sleep when you need to....at night....
Peace and love to you as you start on this new journey to a calmer and happier place...
Stargazer
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